Lead Care Manager

Serene Health•Torrance, CA

7d•$25 - $28

About The Position

The Lead Care Manager (LCM) develops personalized care plans, coordinates member services, and collaborates with members, families, Primary Care Providers, and care teams to ensure members receive appropriate medical treatment and support. The LCM consults with members to determine their needs, develops individualized action plans, and manages the member experience. Key aspects of the role include providing emotional support, resolving administrative issues, and helping members access care promptly. The position serves a diverse population enrolled in the Enhanced Care Management program, including one or more of the listed populations of focus. The populations of focus include people experiencing homelessness; people at risk for avoidable hospital or emergency department use; people with serious mental health or substance use needs; people transitioning from incarceration; adults at risk for long-term care institutionalization; nursing facility residents transitioning to the community; children and youth enrolled in CCS or CCS WCM with additional needs; children and youth involved in child welfare; adults with intellectual or developmental disabilities who qualify for another adult ECM population of focus; and pregnant or postpartum individuals who meet the specified ECM eligibility criteria or are subject to racial and ethnic disparities. The role requires member outreach by telehealth and in-person visits, including travel in a personal vehicle. Full-time employees may enroll in the listed benefits after 60 days of employment; 401(k) eligibility is effective after one year. Employment is contingent on successful pre-employment drug screening and a background check, and the workplace is drug-free.

Requirements

High school diploma or GED.
At least 1 year of experience in case management, member care, customer service, call center, or member care.
Valid California driver's license and valid vehicle insurance.
Excellent communication, interpersonal, customer service, and organizational skills.
Computer skills for documentation, email, and chat support.
Ability to work independently and collaboratively with a team to provide member care.
Ability to multitask, stay organized, and maintain attention to detail while providing care to multiple members simultaneously.
Ability to use resources effectively to solve problems and remain composed under pressure in a compassionate manner.
Proficient speaking, reading, and typing abilities, with strong proofreading skills.
Ability to travel in a personal vehicle for outreach visits.
Must successfully complete and maintain current Tuberculosis (TB) testing and clearance in accordance with company policy and applicable local and state health regulations.
Ability to sit for prolonged periods at an office desk using a computer.
Ability to lift up to 15 lbs.

Nice To Haves

Medical assistant certificate or knowledge of medical terminology.

Responsibilities

Interview members to assess medical and social determinant of healthcare gaps, provide education about conditions and medications, and develop individualized care plans.
Respond to member inquiries and concerns while ensuring adherence to hospital and legal requirements.
Collaborate with interdisciplinary teams, locate medical and social resources, and coordinate social service plans.
Maintain ongoing contact with members through telehealth and in-person visits.
Advocate for members, consult with healthcare providers, arrange appointments and treatment plans, evaluate member progress, and assist with healthcare barriers.
Communicate with members and families with empathy and professionalism.
Support behavioral health coordination, substance abuse services, and community resources.
Perform additional duties as assigned.